Tuesday, August 11, 2015

Links between asthma and COPD

Asthma is no longer considered a Chronic Obstructive Pulmonary Disease (COPD). Experts now consider asthma and COPD as completely different disease entities with unique treatment regimes. Still, there remain many similarities, and here are 15 of them.

Past. Both diseases have a similar history. Asthma was defined for the medical community around 400 B.C. by Hippocrates. COPD was defined for the medical community about 200 years ago, although was probably confused under the umbrella term asthma prior to that. Somewhere along the way the roles were reversed and asthma was linked under COPD. Now they are both solo diseases.

Symptoms. Explaining why these two diseases were confused for each other for most of history is that symptoms are very similar. They both present with shortness of breath, chest tightness, coughing and wheezing.

Triggers. Symptoms are caused by exposure to substances in the air that are innocuous (harmless) to most people, such as common allergens (dust, molds, fungus, pollen), cold winter air, strong smells, and exercise. Asthma triggers are similar, but not always the same, as COPD triggers.

Inflammation. They both are associated with chronic (it’s always there) inflamed air passages. This makes the air passages hyper-responsive (or over-responsive) to triggers.

Obstructive. Exposure to triggers causes an abnormal reaction that worsens inflammation and causes the muscles that wrap around the air passages to spasm, thus squeezing the airways. Increased sputum production further blocks air passages.

Acute. They are both associated with acute (it’s happening now) exacerbations. This is what we call asthma attacks or COPD flare-ups. Such acute episodes can be controlled and prevented (or the severity lessened) by following a treatment regime.

Reversible. Acute episodes of both diseases are reversible. However, asthma episodes are completely reversible, while COPD episodes are only partially reversible.

Intervals. Both present with intervals between acute episodes. Asthmatic lung function should be normal during intervals allowing asthmatics to live a normal quality of life between attacks so long as a treatment regime is followed. COPD lung function may always be somewhat compromised, although a treatment regime may improve lung function leading to an improved quality of life.

Chronic. Both diseases are chronic, meaning they are always there. For this reason, both asthmatics and COPDers must always work with their physicians to develop a treatment regime to prevent acute episodes, and plans for what to do when symptoms are observed.

Plans. Part of the treatment regime for both diseases is working with a physician to create either an Asthma Action Plan or COPD Action Plan. These help patients decide what to do when symptoms are felt and an acute attack/ flare-up is imminent or ongoing. Medicine. Part of the treatment regime for both diseases also includes a combination of inhalers and nebulizer solutions to control and prevent symptoms. While some medicines are only approved for asthma (Advair), and some only for COPD (Breo), they are sometimes prescribed for either disease.

Diagnosis. There is no definitive test for diagnosing either disease. Diagnosis is usually accomplished by a series of tests (such as PFTs), symptom monitoring, and clinical assessment by a physician.Beware. Sometimes asthma and COPD co-exist. Severe, untreated, or difficult to control asthma may lead to permanent airway changes and cause COPD. Smoking when you have asthma may also cause COPD. Still, sometimes COPDers have asthma and the reason is unknown. So there are times when these two diseases overlap.

Lifestyle. Most victims of these diseases will need to make certain lifestyle changes in order to make intervals long and episodes mild when they do occur. They must continue to work with a physician, learn to take medicine every day, and avoid triggers.

Future. Scientists and researchers continue to work overtime to learn more about these diseases, invent improved medicine, discover better treatment regimes, and provide hope for cures in the future.

Quality. Asthmatics should be able to live a normal quality of life. COPDers should be able to delay progression of the disease and remain productive members of society for many years. The trick is to work with a physician to develop a treatment regime that works for you.